CAR T-cell therapy has been particularly successful for
adults with CLL and for adults and children with ALL
(123-125). In fact, a recent study indicates that 86 percent
of pediatric patients with ALL experienced complete
remissions, and one patient remains in remission 20 months
a;er initiating treatment (126). Although this therapy is
promising, some children eventually relapse.

Researchers are currently working to develop CAR T
cells that will target other types of cancer, including acute
myeloid leukemia, multiple myeloma, and some solid
tumors, but the research is in the very early stages (127,
128). As research continues to increase our understanding
of why CAR T-cell therapy does not work for all patients,
new and more e;ective CAR T-cell therapies are likely to
emerge in the future (128).

Tumor-in;ltrating lymphocyte therapy (TIL therapy) is an
experimental approach primarily used to treat patients with
metastatic melanoma. Since its development 12 years ago
(129), it is estimated that durable responses occur in about
one in every ;ve patients with metastatic melanoma and
that many of these individuals, like Roslyn Meyer (who was
featured in the AACRCancer Progress Report 2011), have
ongoing responses (130).

Until recently, TIL therapy has largely been limited to the
treatment of melanoma. However, new reports indicate that
it may be causing tumor regression for one patient with bile
duct cancer and complete, ongoing responses for two patients
with cervical cancer (131, 132). ;us, TIL therapy may one
day bene;t patients with a wide range of cancer types.

;e majority of patients treated with TIL therapy also
receive high doses of the cytokine IL- 2 to give the
transferred T cells a boost, and it is the IL- 2 that causes the
most severe adverse e;ects of the treatment. Researchers are
investigating a number of ways to overcome this problem,
including engineering less toxic forms of IL- 2 (133). ;is is
important because even though IL- 2 was approved by the
FDA to treat metastatic melanoma and renal cell carcinoma
in 1998, it is not used very o;en because of its toxic, even
lethal, side e;ects. When it is used, however, recent results
show that high-dose IL- 2 can lead to durable responses
(134, 135).

;erapeutic cancer vaccines enhance the killing power
of the immune system by training the patient’s T cells,
while they are inside the patient’s body, to recognize and
destroy the patient’s cancer cells. ;e development of these
immunotherapeutics is an intensively studied area of cancer
research. In fact, in the United States alone, several hundred
ongoing clinical trials are testing therapeutic cancer
vaccines.

One therapeutic cancer vaccine being tested as a treatment
for the most aggressive form of brain cancer, glioblastoma
multiforme (GBM), in a large-scale clinical trial, a;er
showing promise in early stage clinical trials, is DCVax-L
(136). DCVax-L is a cell-based vaccine whereby each
patient receives a customized treatment that uses dendritic
cells from his or her own body to boost cancer-;ghting
T cells. As a result of the immense potential of this
immunotherapeutic, in March 2014, the Paul Ehrlich
Institute—the German equivalent of the FDA—approved
the use of DCVax-L for the treatment of patients with GBM
and less aggressive forms of the disease through an early
access program.

Living With or Beyond Cancer

As a result of advances in cancer research, more people
are surviving longer and leading fuller lives a;er a
cancer diagnosis than ever before. In fact, the number of
U.S. residents living with, through, or beyond cancer is
estimated to have risen to almost 14. 5 million, compared
with just 3 million in 1971 ( 2, 3). ;is 14. 5 million includes
an estimated 379, 112 individuals who, like Jameisha
(Meisha) Brown (see p. 72), received their cancer diagnoses
as children or adolescents (ages 0– 19) ( 1). ;ese individuals
are considered cancer survivors, although it is important
to note that not all people who have received a cancer
diagnosis identify with this term.

Cytokines

are molecules naturally released by
immune cells that alter the function
of other immune cells. Cytokines
such as interleukin 2 (IL- 2) boost
T-cell function, including the ability
to eliminate cancer cells.